Exercises for sciatica: herniated or slipped disc

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In this video physiotherapist Sammy Margo demonstrates gentle exercises for sciatica caused by a herniated or slipped disc. The aim of these exercises is to reduce the pressure on the nerve caused by the slipped disc, and reduce the inflammation around it. This video is part of a series on exercises for sciatica.

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Transcript of
Exercises for sciatica: herniated or slipped disc

EXERCISES FOR SCIATICA HERNIATED OR SLIPPED DISC I'm Sammy Margo.I'm a chartered physiotherapist. Today I'm going to talk to youabout exercises for a herniated or slipped disc. But first we need to understand a littlebit about the anatomy of the spine and where the disc is. So, this being the spine,this is the skull. This is the pelvis. These are the verte ae. The yellow things are nerves that arein between each one of the verte ae. These are the discs which are like washers in betweeneach one of the verte ae. What happens with a herniated disc is the disc material comes outa little bit. It puts pressureon the surrounding area. It can be just locally or on the nerve.If it's on the nerve, it may well cause pain down the leg,sciatica, into the buttock,into the back of the thigh, or into the calf and even into the foot. The main aim is to take the pressureoff the nerve and help reduce the inflammation. We're looking to give this area spaceso that it can eathe. First I'm going to show you somepositions of comfort you can get into to help alleviate the painfrom a herniated disc. Come along onto your tummy, please. And if you can, lie on your tummy. If you do have this problem, you mightnot get into this position so easily. Lie yourself down flat. Head down. In so doing,we're opening up the low back. That will allow things to settle down. This can help alleviate painin this area, in the buttock, in the hamstring,in the calf and in the foot. The main aim is to take the pressureoff this area. Lying in this position for a whilecan help settle down your symptoms. It's quite trickyto get into and out of, but it's a position worth doing. Moving onto the next position, can youcome and lie on your side, please? Lying on your side can sometimes helpalleviate the discomfort. Again, you might not be able to moveinto that position that easily. It's quite often your problem sideis uppermost. Can you bend your kneesa little bit more? Both of them? We're getting into a foetal positionwhich again gaps the area. I'm placing a pillow between your knees, particularly for those of youwith an hourglass figure. That can help settle things down and allow the spine to bein a more comfortable position. Just lying facing that way. OK? If you're lying on the floor, you might want to put somethingunder the side to flatten the area. Sometimes lying in this position canhelp alleviate the pain. It's for you to figure out whether thisis helping alleviate the pain. Come and roll onto your back, please. Lying on your back,often putting a pillow... Lie yourself down flat...under your knees. What we often do if this positionis not quite giving you relief... It will give you reliefbecause it's softening your low back. We often build up pillows a little bitmore, put more pillows under your knees. For some people, we even put a chairon the bed or they lie on the floor. By being in this position, that will help alleviate your low backand gap the area. Even lying on your backwith your legs on a chair can help take the pressure off the area. We're going to move on to exercises now.Just put your feet down. Again, the main aim isjust to be very gentle. Gentle exercises,just to help prevent any muscle atrophy and keep things moving. If any of these give you painor discomfort, you must stop. The way to do it isjust some gentle pelvic tilting. So, if you feel my hand, squash my hand down while you'resucking your tummy muscles in. Again, you're gapping the joint, holdingit there, starting to wake things up. You often do get some muscle atrophy.The muscles switch themselves off. We want to keep working things. Relax. And again.Squash down as hard as you can, but holding each one for five seconds. You can do those ten times.Obviously, I won't be there. If you want to have a go at puttingyour hand under your back yourself... And just push down. Holding it, holding it, holding it. If you feel any pain or discomfort,stop and let it go. That's a very good one to get going.You need to do ten of those. The next one is buttock squeezing. And squeezing your buttocks. Squeezing your buttocksas hard as you can. And relax. None of this should give youany pain or discomfort. You can do ten of those,holding each one for five seconds. When you feel ready, it's very important to return to workor to activity as soon as possible, however moderate it is. So, think about swimmingor cycling or gentle walking. Just some rhythmical exercisesthat won't aggravate you, that will just get you going. The sooner you return,the better you'll be. It's very important that you haveproper resolution of your herniated disc so you don't get another recurrence. So, a return to activityas soon as possible. Respect the pain.Also, look at things like weight. Weight is a big thing that can actuallyput a lot of strain on your discs. Your posture at work, be it in the car,be it at your desk... Your posture in bed,what position you're lying in. Make sure that your spineis well-supported. And exercises. We're leading sedentary lifestyles.You've got to keep strong. Make sure you're taking eaksduring the day at work, going for walks,keeping strong and keeping mobile. IF YOU EXPERIENCE ANY PAINOR DISCOMFORT WHILE DOING THESE EXERCISES PLEASE STOPAND CONSULT YOUR GP. FOR MORE INFORMATION GO TO:www.nhs.uk/sciatica